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PSA Screening Saves Lives

The European Randomized Study of Screening for Prostate Cancer (ERSPC) was started more than 20 years ago and included more than 180, 000 men, only half of whom underwent regular PSA testing. Results from 11 years of  follow-up were published in the New England Journal of Medicine in 2012 and showed that PSA screening prevented one death from prostate cancer for every 1, 000 men screened over a decade. 

An abstract presented at the 29th Congress of the European Association of Urology on April 15, 2014 presented updated results after 13 years of follow-up. For the first time the trial demonstrated PSA screening of men between 50 to 74 years of age significantly reduced prostate cancer metastases and mortality. Prostate cancer mortality was reduced 50% in men who started screening before age 60 and 20% in men who started PSA screening after age 60.

The number of men needed to invite for screening to prevent 1 prostate cancer death is now estimated to be 781. The number needed to diagnose to prevent 1 death is 27.

The incidence of prostate cancer was increased 57% in the screening group compared with the control group. This updated report verifies that the biggest risk of prostate cancer screening is potential harm associated with overdiagnosis and overtreatment.

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